Examination of urothelial cancer is usually performed by staining cells dropped out in the urine by Papanicolaou stain and observing them with a microscope. However, proficiency is required to diagnosis, and there are often oversights, which is a problem. The difficulty of detection leads to the delay in cancer detection, and thus to miss relapse.
On the other hand, in the endoscopic operation for a bladder cancer patient, it is known to inject ALAs into bladder, observe the fluorescence derived from cancer cells in the bladder to determine the excision site (see for example, Nonpatent Document 1). It is also known that the observation of fluorescence in the bladder is possible by administering orally or injecting intravenously ALAs (see Patent Document 1).
Further, a diagnostic agent for tumor comprising ALAs is proposed, which agent is intended to determine the presence or absence of tumor in tissues of brain, nasal tract, nasal cavity, trachea, bronchi, buccal cavity, pharynx, esophagus, stomach, breast, colorectum, lung, ovary, central nervous system, liver, bladder, urethra, urinary duct, pancreas, cervical duct, abdominal cavity, anal duct, or cervix uteri, by administering the diagnostic agent for tumor in an amount of 0.001 mg to 10 g per kg of body weight at a time, measuring protoporphyrin IX, uroporphyrin I, coproporphyrin I, etc. in a sample collected in vivo or in vitro such as blood, body fluid, tissue, urine, feces, saliva, sweat, spinal fluid, seminal fluid, or tears to diagnose tumor (see for example Patent Document 2).
Further a PDD cytology method targeting fluorescence exfoliated cells in the urine, comprising performing fluorescence cytology and flow cytometry for detecting ALA-induced fluorescence positive cells is reported, which method comprises in vitro incubation method comprising dissolving urinary sediment collected from a bladder cancer patient into a serum free culture solution with an ALA concentration adjusted to 200 μg/mL, and keeping the heat at 37° C. for 2 hours in a dark room before subjecting the resultant to the test; and in vivo incubation method subjecting the urinary sediment collected from ALA solution (1.5 g ALA/50 mL buffer) kept in the bladder of a bladder cancer patient for 2 hours to the test (see for example Nonpatent Document 2).